What is HSR?

Health Services Research (HSR) is a multi-disciplinary research activity with an implicit objective of improving the health services patients receive. Thus it is an area of applied rather than 'basic' research - it uses theories of human behaviour from contributing disciplines, along with evidence from the medical sciences, to generate and test hypotheses about the delivery of health care.

Improvement of health services has many dimensions: better quality care (including care that is effective, timely and appropriate), more accessible care, more equal distribution of health gains from health services, safer care, and improved efficiency, both allocative and technical, in the provision of health care.

HSR differs from single-discipline research in that it seeks to understand these dimensions from multiple perspectives. It calls on knowledge from the contributing direct service disciplines of medicine, nursing, allied health, and psychology to understand dimensions of effectiveness, quality and safety of direct care in all its forms. It calls on the disciplines of psychology, sociology, political science, management science and health economics, to understand the social dimensions of care: access, distribution, timeliness, efficiency.

While HSR shares a concern for improvement of health services with practitioners of 'big-P' health policy (health ministers, senior bureaucrats), it is distinguished by its emphasis on a research basis for policy, in contrast to big-P policy practitioners who must consider expedient policy solutions and electoral support. HSR is underpinned by a belief that systematic investigation of health services, and the systems in which they are provided, is helpful in improving health outcomes.

The focus on services is what distinguishes HSR from other multidisciplinary health research activities. Population health (and most of 'public health') rightly focuses on the antecedents to ill-health and explanations for the distribution of health and disease. 'Public health' is historically an amalgam of population-based measures (eg, sanitation) and individual health services (eg, immunisation), but public health research is usually not principally 'service' focussed.

The audience for HSR extends across a broad spectrum, from innovators in bioscience to experts in indigenous health. Practitioners and researchers share an interest in understanding how health services contribute to their own domains and how they can be improved to increase the welfare of society more generally.